My 5 year old type 1 is going in for surgery on Monday. She will be having 4 teeth pulled and some filled and capped. I am so nervous!!! This is the 1st time she will be under full sedation and I don’t really know what to expect… Does anyone have any advice??? Also her doctors say that there is no connection between her diabetes and her tooth decay but she brushes and flosses and uses mouth wash. She has already had 3 teeth removed 3 years ago. Has anyone had any of the same problems???
hi @ncarolina3,
okay so when I needed to have surgery, I had a nice talk with the surgeon and doctors at the hospital regarding my blood sugar control. The doctors wrote in my “chart” that I alone was “in charge” of my blood sugar control which allowed me to give my own insulin in the hospital. This was major because if it’s not in the chart, there might be controversy about how to control her blood sugar.
I pump so I gave explicit instructions that my pump be left on, that no glucose IV’s were to be administrated, unless I got into some trouble during surgery; and I negotiated that my basal rate would be reduced by 33%, by me, so that I had no chance of a hypo while out (I wasn’t sedated I was under general anesthesia) this was another huge thing to work out before surgery.
have the talk with the surgeon and attending doctor. better before than after. figure out what you and your daughter need from the hospital (if anything ) for blood sugar control.
neither sedation nor anesthesia had any affect on my blood sugar, but some people react to stress so it’s important to check and adjust. before my appendix surgery I got a little low and had the doctor put in the equivalent of 15 grams glucose in my IV bag, in my life I never had a low go away that fast, and the staff was happy that my 55 turned into 130 in about 10 minutes.
as far as the teeth… I don’t have much to add. sorry. good luck, we are rooting for your daughter.
Hi @ncarolina3,
I will echo just about everything that @joe has said. Discuss the diabetes management ahead of time with your daughter’s doctors and if you are comfortable with everything be there to control her diabetes; you may know more about her and diabetes management than the surgeon. As you know, this will be a multi-day adjustment - be very careful with what she eats on Sunday, measure and carefully calculate insulin doses so as not to “stack” insulin in her that could cause her BG to drop during the long fast before anesthesia.
In my many years with T1, I’ve had several surgeries and I’ve always told the surgeon ahead of time how I’d manage insulin and that I plan to have my BG “high” ]about 150 mg/dl] before going under. A usual practice for me is to lower my pump basal to 50% about 9 PM before surgery - and then check BG every few hours to be certain that I don’t go too high. Does your daughter pump?
I still have all my teeth, except for three wisdom teeth pulled many years ago. I have had several route canals done and those teeth capped - it has been many years I’ve had any cavities.
Best wishes for her, and mama, relax if you can knowing that you are doing an awesome job.
I know it’s been almost two months since the last reply, but I’ll add my $0.02 U.S. just in case future readers could benefit.
When I had my wisdom teeth removed, I talked with my endocrinologist about a plan for the time that I was required to fast. She gave me a sliding scale of how much to bolus for various ranges of blood sugar readings and instructions for what to do if I had a low. (Note: I’m a long-time pump patient.)
I was sure to remind the staff in the endodontist’s office to not give me a glucose IV drip; anesthesia only.
In fact, I need to ask my endocrinologist this week for the same instructions — I have a surgical procedure next Wed. (Fun times. Not!)
Hope everything went well with your son’s dental procedure, @ncarolina3. 